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Stem cell transplant for neuroblastoma
A stem cell transplant is sometimes used to treat neuroblastoma. Stem cells are found in the bone marrow, the bloodstream and umbilical cords. They are basic cells that develop into different types of cells that have different jobs. For example, all our blood cells develop from blood stem cells.
A stem cell transplant is used to replace stem cells when stem cells or the bone marrow are damaged. They can be damaged by disease or destroyed by high doses of chemotherapy or radiation therapy. Your child may be offered high-dose chemotherapy with a stem cell transplant (sometimes called stem cell rescue) to treat neuroblastoma if it:
- is high risk
- has spread to other parts of the body
- has recurred, or come back, after treatment
A stem cell transplant is a complex procedure that must be done in specialized transplant centres or hospitals.
Autologous stem cell transplant
In this type of transplant, the stem cells are taken from the child’s own bone marrow or blood and are frozen and stored. After chemotherapy is given, the stem cells are thawed and given back to the child.
The following chemotherapy drugs may be used for high-dose chemotherapy before stem cell transplant:
- busulfan (Busulfex, Myleran) and melphalan (Alkeran, L-PAM)
- carboplatin (Paraplatin, Paraplatin AQ), etoposide (Vepesid, VP-16) and melphalan
Radiation therapy may be given after stem cell transplant. Maintenance therapy with retinoids and immunotherapy is also given for about 6 months after stem cell transplant. These treatments are used to kill any remaining cancer and lower the risk that the cancer will come back, or recur.
Side effects can happen with any type of treatment for neuroblastoma, but every child’s experience is different.
Side effects can develop any time during, immediately after or a few days or weeks after a stem cell transplant. Sometimes late side effects develop months or years after a stem cell transplant. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.
Side effects of a stem cell transplant will depend mainly on the type of chemotherapy drug or drug combination given, if radiation therapy was given and the child’s overall health. Common side effects of a stem cell transplant include:
- low blood cell counts
- graft-versus-host disease (GVHD)
- digestive system problems
Other side effects can develop months or years after treatment for neuroblastoma. Find out more about late effects for neuroblastoma.
Tell your child’s healthcare team if your child has side effects you think might be from a stem cell transplant. The sooner you tell them of any problems, the sooner they can suggest ways to help your child deal with them.
Questions to ask about stem cell transplant
A condition that might happen after a stem cell transplant. Healthy stem cells from a donor (called the graft) attack a recipient’s (receiver’s) cells (called the host). The graft cells see the host cells as foreign and start to destroy them. Symptoms include jaundice, rash or blisters on the skin, dry mouth or dry eyes.